The reasons why fractional flow reserve and instantaneous wave-free ratio are similar using wave separation analysis

Autor: Soohong Min, Gwansuk Kang, Dong-Guk Paeng, Joon Hyouk Choi
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: BMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-12 (2021)
Druh dokumentu: article
ISSN: 1471-2261
54919908
DOI: 10.1186/s12872-021-01855-4
Popis: Abstract Background and objectives Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are the two most commonly used coronary indices of physiological stenosis severity based on pressure. To minimize the effect of wedge pressure (P wedge ), FFR is measured during hyperemia conditions, and iFR is calculated as the ratio of distal and aortic pressures (P d /P a ) in the wave-free period. The goal of this study was to predict P wedge using the backward wave (P back ) through wave separation analysis (WSA) and to reflect the effect of P wedge on FFR and iFR to identify the relationship between the two indices. Methods An in vitro circulation system was constructed to calculate P wedge . The measurements were performed in cases with stenosis percentages of 48, 71, and 88% and with hydrostatic pressures of 10 and 30 mmHg. Then, the correlation between P back by WSA and P wedge was calculated. In vivo coronary flow and pressure were simultaneously measured for 11 vessels in all patients. The FFR and iFR values were reconstructed as the ratios of forward wave at distal and proximal sites during hyperemia and at rest, respectively. Results Based on the in vitro results, the correlation between P back and P wedge was high (r = 0.990, p
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